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Lower extremity compartment syndrome in northern Ghana

Kuubiere B. Callistus and Abass Alhassan

Compartment syndrome is a condition in which increased pressure within a closed compartment compromises circulation and function of the tissues within that space. This usually occurs in osseofascial compartment of the leg or forearm, but it may occur in the upper arm, thigh, foot, buttock, hand, and abdomen. The general cause of compartment syndrome is trauma, usually after a fracture. The incidence rate of acute compartment syndrome is up to 20% in acutely ischaemic limbs but can vary from one place to the other. Delays in treatment can result in significant disability including neurological deficit, muscle necrosis, amputation, and death. However, very little is known about the prevalence of this condition in the Northern part of Ghana. The aim of the study was to investigate the prevalence of acute lower extremity compartment syndrome and its causes in Northern Ghana over a five year period. The study setting was the Tania specialist orthopaedic hospital, Tamale, Ghana. Data regarding patient's age and sex, extremity involved, cause of injury from January, 2007 to December, 2012 were analysed retrospectively. The prevalence of compartment syndrome over the study period was 20.76%. Majority of the cases were a result of non-infected fractured limb (48.17%), followed by infected fractured wounds, 25.23%, Gun-shot wounds, 15.60%, burns, 7.34% and others 3.67%. Among the non-infected fractured wounds majority (52.38%) were a result of prolong immobility with back slap POP with gauze bandage. In conclusion the prevalence of acute lower extremity compartment syndrome in Northern Ghana is relatively high. High energy injuries such as those sustained from road traffic accidents and gunshots as well as traditional bonesetter splinting are the most predominant precursors for lower extremity compartment syndrome in this part of Ghana. Monitoring of compartment pressure in these patients as wells as early referrals for specialist orthopaedic and trauma management should be considered to allow for early detection and treatment